1
|
Acute Effects of Different Intensities of Cycling Acute Exercise on Carotid Arterial Apparent Elasticity and Hemodynamic Variables. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9027560. [PMID: 33224984 PMCID: PMC7669336 DOI: 10.1155/2020/9027560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
Background Cardiovascular disease (CVD) is closely related to arterial elasticity and hemodynamics. Exercises have been reported to immediately decrease arterial apparent elasticity and regulate hemodynamic variables. However, the relationship between them and exercise intensity remains elusive. The purpose of this study was to determine the acute effects of different intensities of acute cycling exercise on carotid arterial apparent elasticity and hemodynamics. Methods 32 healthy men (age: 19.4 ± 0.6 years) attended the laboratory on five occasions and completed cycling acute exercise for 20 minutes at five intensities (40%, 50%, 60%, 70%, and 80% heart rate reserve (HRR)). At the right carotid artery, center-line velocity and arterial inner diameter waveforms were examined before and immediately after exercise. Based upon the measured data, the classical hemodynamic theory was used to calculate the apparent elasticity and the local hemodynamic variables. Results The arterial apparent stiffness and the apparent elastic modulus following acute cycling exercise at 60% to 80% HRR were significantly higher than baseline. The mean center-line velocity accelerated from 50% to 80% HRR, but no intensity of intervention altered mean blood flow. Immediately after intervention, the mean wall shear stress and oscillatory shear index increased. Conclusions Aerobic cycling intervention, with intensity from 40% to 80% HRR, did not change the brain blood supply. A bout of cycling intervention decreased apparent elasticity, and there was an intensity-dependent effect on apparent elasticity and hemodynamic variables. This study would provide referable data for the further study on the effects of aerobic exercise on arterial hemodynamics and elasticity and underlying physiological mechanisms.
Collapse
|
2
|
Wilms B, Ernst B, Schmid SM, Thurnheer M, Weisser B, Schultes B. Spiroergometric assessment of cardiorespiratory fitness in subjects with severe obesity: A challenge of reference. Nutr Metab Cardiovasc Dis 2019; 29:1382-1389. [PMID: 31558415 DOI: 10.1016/j.numecd.2019.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/10/2019] [Accepted: 07/18/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Severe obesity is associated with poor physical performance but objective data are scarce. METHODS AND RESULTS Bicycle spiroergometry data with focus on peak oxygen uptake (V˙O2,peak) and workload (Wpeak) from 476 subjects with severe obesity (BMI ≥ 35.0 kg/m2; 70% women) were analysed. In a first step, V˙O2,peak values were compared with reference values calculated upon different formulas (Wassermann; Riddle). Thereafter, multivariate regression analyses were performed to identify determinants of cardiorespiratory fitness. Cardiorespiratory fitness reference classes for V˙O2,peak and Wpeak were established by stratifying the sample upon identified determinants. Absolute V˙O2,peak (1.87 ± 0.47 vs. 2.40 ± 0.59 l/min) and Wpeak (131 ± 26 vs. 168 ± 44 W) were lower in women than men (both p<0.001). Same pattern was found for relative V˙O2,peak and Wpeak, respectively (both p < 0.05). In women, measured V˙O2,peak was lower than predicted by Wasserman (p < 0.001) but not by Riddle (p = 0.961). In men, V˙O2,peak was lower than calculated by both Wasserman and Riddle formulas (both p ≤ 0.003). Multivariate analyses revealed height and age to be the main determinants of cardiorespiratory fitness in both sexes. Subsequent statistical analyses of calculated reference fitness classes revealed that V˙O2,peak and Wpeak differed between the age- and height-defined groups in both sexes (all p < 0.001). CONCLUSION Data indicate that the evaluation of cardiorespiratory fitness in subjects with severe obesity is largely biased by selected references values for comparison. Our newly established reference fitness classes upon height and age might be helpful in the clinical context when dealing with obese patients.
Collapse
Affiliation(s)
- Britta Wilms
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Barbara Ernst
- Metabolic Center St. Gallen, friendlyDocs Ltd., St. Gallen, Switzerland
| | - Sebastian M Schmid
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | | | | | - Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd., St. Gallen, Switzerland
| |
Collapse
|
3
|
Van de Poppe DJ, Hulzebos E, Takken T. Reference values for maximum work rate in apparently healthy Dutch/Flemish adults: data from the LowLands fitness registry. Acta Cardiol 2019; 74:223-230. [PMID: 29933724 DOI: 10.1080/00015385.2018.1478763] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: The peak oxygen uptake (VO2peak) test is the gold standard for cardiorespiratory fitness. However, the test is demanding, requiring sophisticated apparatus for measuring the oxygen uptake. Peak work rate (WRpeak) testing is a promising substitute for peak VO2peak testing. However, there is a paucity of research conducted to determine reference values (RVs) for WRpeak. Methods: The database from the LowLands fitness registry was used, containing data from health checks from apparently healthy subjects among various professions. Exercise tests were performed using a cycle ergometer and a calibrated metabolic cart. Analysis was executed on 3463 subjects, 2868 male and 595 female. Reference values with corresponding centiles were developed using the LMS method. Results: VO2peak and WRpeak where highly associated with Pearson's correlation of 0.9 (p = .001). Weight, height, maximum heart rate, and the respiratory exchange ratio had a positive significant effect (p < .001) on WRpeak, and age a negative significant effect, in both males and females. The following formulas were computed for RVs: WRpeak=-102+(1.5 * weight[kg])+(1.9 * height[cm])-(2.0 * age)-(sex * 60[M:0;V:1]) WRpeak/kg=2.45-(0.026 * weight[kg])+(0.024 * height[cm])-(0.024 * age)-(sex * 0.84 [M:0;V:1]) Conclusions: WRpeak can be used as a substitute for VO2peak when a respiratory gas-analysis system is not available. This study provides RVs for WRpeak and WRpeak/kg in a healthy Dutch/Flemish adult population using cycle ergometry. Further research is needed to obtain RVs for elderly subjects, specific diseases, ethnicities and ergometers.
Collapse
Affiliation(s)
- D. J. Van de Poppe
- Faculty of Medicine, Utrecht University, UMC Utrecht, Utrecht, The Netherlands
| | - E. Hulzebos
- Child Development & Exercise, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- The Physiology Academy, Alphen aan den Rijn, The Netherlands
| | - T. Takken
- Child Development & Exercise, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- The Physiology Academy, Alphen aan den Rijn, The Netherlands
| | | |
Collapse
|
4
|
Butter C, Groß J, Haase-Fielitz A, Sims H, Deutsch C, Bramlage P, Neuss M. Impact of Rehabilitation on Outcomes after TAVI: A Preliminary Study. J Clin Med 2018; 7:jcm7100326. [PMID: 30301135 PMCID: PMC6210128 DOI: 10.3390/jcm7100326] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/21/2018] [Accepted: 10/02/2018] [Indexed: 12/23/2022] Open
Abstract
The benefit of rehabilitation in elderly patients undergoing transcatheter aortic valve implantation (TAVI) for treatment of severe aortic stenosis is unknown. The impact of declining rehabilitation programs on mortality has also not been described. In a longitudinal cohort study of 1056 patients undergoing elective TAVI between 2008 and 2016, logistic regression analysis was used to assess the relationship between treatment modality and outcome according to whether or not patients participated in a three-week rehabilitation program after TAVI. Subgroup analyses included patient outcome separated according to cardiac, geriatric, or no rehabilitation. A total of 1017 patients survived until hospital discharge (96.3%) and were offered rehabilitation, 366 patients (36.0%) declined to undergo rehabilitation, with the remaining patients undergoing either cardiac (n = 435; 42.8%) or geriatric rehabilitation (n = 216; 21.2%). Mortality at six months was lower for patients receiving rehabilitation compared with those who had not (adjusted odds ratio (OR): 0.49; 95% confidence interval (confidence interval [CI]: 0.25–0.94; p = 0.032). Sub-analysis showed the benefit of cardiac (adjusted OR: 0.31; 95% CI 0.14–0.71, p = 0.006), but not geriatric rehabilitation (adjusted OR 0.83; 95% CI 0.37–1.85, p = 0.65). A program of rehabilitation after TAVI has the potential to reduce mortality. Future studies should focus on health-orientated behavior and identifying risk factors for declining rehabilitation programs.
Collapse
Affiliation(s)
- Christian Butter
- Department of Cardiology, Heart Center Brandenburg, Bernau 16321, Germany.
- Brandenburg Medical School (MHB) "Theodor Fontane", Neuruppin 16816, Germany.
| | - Jessica Groß
- Department of Cardiology, Heart Center Brandenburg, Bernau 16321, Germany.
- Brandenburg Medical School (MHB) "Theodor Fontane", Neuruppin 16816, Germany.
| | - Anja Haase-Fielitz
- Department of Cardiology, Heart Center Brandenburg, Bernau 16321, Germany.
- Brandenburg Medical School (MHB) "Theodor Fontane", Neuruppin 16816, Germany.
| | - Helen Sims
- Institute for Pharmacology and Preventive Medicine, Cloppenburg 49661, Germany.
| | - Cornelia Deutsch
- Institute for Pharmacology and Preventive Medicine, Cloppenburg 49661, Germany.
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg 49661, Germany.
| | - Michael Neuss
- Department of Cardiology, Heart Center Brandenburg, Bernau 16321, Germany.
- Brandenburg Medical School (MHB) "Theodor Fontane", Neuruppin 16816, Germany.
| |
Collapse
|
5
|
Manzoni C, Carrard A, Fontana E, Lemay M, Bertschi M, Delgado-Gonzalo R. Towards VO 2 monitoring: Validation of a heart rate based algorithm. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1780-1783. [PMID: 29060233 DOI: 10.1109/embc.2017.8037189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article presents and validates a novel algorithm for the continuous monitoring of the VO2 during exercise. The algorithm relies on instantaneous HR measurements to provide a continuous estimation, and can be integrated in a wearable device (e.g., smartwatch, sensor patch). It can be customized by user's main anthropomorphic parameters and automatically learns from newly incoming data recalibrating itself if needed. The system is evaluated against a database of 14 healthy subjects performing various maximal endurance tests. The proposed method provides a VO2 estimation with average RMSE of 4.63 ml/kg/min.
Collapse
|
6
|
Gar C, Rottenkolber M, Grallert H, Banning F, Freibothe I, Sacco V, Wichmann C, Reif S, Potzel A, Dauber V, Schendell C, Sommer NN, Wolfarth B, Seissler J, Lechner A, Ferrari U. Physical fitness and plasma leptin in women with recent gestational diabetes. PLoS One 2017; 12:e0179128. [PMID: 28609470 PMCID: PMC5469459 DOI: 10.1371/journal.pone.0179128] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 05/24/2017] [Indexed: 12/15/2022] Open
Abstract
Aims/Hypothesis Low physical fitness (PF) is a risk factor for type 2 diabetes mellitus (T2D). Women with a history of gestational diabetes (GDM) are at risk for T2D at a young age, but the role of PF in this population is not clear. PF has also been found to correlate inversely with plasma leptin in previous studies. Here, we examine whether women who had GDM have lower PF than women after a normoglycemic pregnancy and, second, whether PF is associated with plasma leptin, independently of body fat mass. Methods Cross-sectional analysis of 236 participants in the PPSDiab Study (cohort study of women 3–16 months after delivery, 152 after gestational diabetes (pGDM), 84 after normoglycemic pregnancy (control subjects); consecutively recruited 2011–16); medical history, physical examination with bioelectrical impedance analysis (BIA), whole body magnetic resonance imaging (MRI) (n = 154), 5-point oral glucose tolerance test, cardiopulmonary exercise testing, clinical chemistry including fasting plasma leptin; statistical analysis with Mann–Whitney U and t -test, Spearman correlation coefficient, multiple linear regression. Results Women pGDM had lower maximally achieved oxygen uptake (VO2peak/kg: 25.7(21.3–29.9) vs. 30.0(26.6–34.1)ml/min/kg; total VO2peak: 1733(1552–2005) vs. 1970(1767–2238)ml/min; p<0.0001 for both), and maximum workload (122.5(105.5–136.5) vs. 141.0(128.5–159.5)W; p<0.0001). Fasting plasma leptin correlated inversely with PF (VO2peak/kg ρ = -0.72 p<0.0001; VO2peak ρ = -0.16 p = 0.015; max. load ρ = -0.35 p<0.0001). These associations remained significant with adjustment for body mass index, or for body fat mass (BIA and MRI). Conclusions/Interpretation Women with a recent history of GDM were less fit than control subjects. Low PF may therefore contribute to the risk for T2D after GDM. This should be tested in intervention studies. Low PF also associated with increased leptin levels–independently of body fat. PF may therefore influence leptin levels and signaling. This hypothesis requires further investigation.
Collapse
Affiliation(s)
- C. Gar
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - M. Rottenkolber
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - H. Grallert
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
| | - F. Banning
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - I. Freibothe
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - V. Sacco
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - C. Wichmann
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - S. Reif
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - A. Potzel
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - V. Dauber
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - C. Schendell
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - N. N. Sommer
- Institut für klinische Radiologie, Klinikum der Universitaet Muenchen, Munich, Germany
| | - B. Wolfarth
- Humboldt Universitaet/Charité, Universitaetsmedizin Berlin, Abteilung Sportmedizin, Berlin, Germany
| | - J. Seissler
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| | - A. Lechner
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
- * E-mail:
| | - U. Ferrari
- Diabetes Research Group, Medizinische Klinik IV, Klinikum der Universitaet Muenchen, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany
| |
Collapse
|
7
|
Nabben M, Schmitz JPJ, Ciapaite J, le Clercq CMP, van Riel NA, Haak HR, Nicolay K, de Coo IFM, Smeets H, Praet SF, van Loon LJ, Prompers JJ. Dietary nitrate does not reduce oxygen cost of exercise or improve muscle mitochondrial function in patients with mitochondrial myopathy. Am J Physiol Regul Integr Comp Physiol 2017; 312:R689-R701. [DOI: 10.1152/ajpregu.00264.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 11/22/2022]
Abstract
Muscle weakness and exercise intolerance negatively affect the quality of life of patients with mitochondrial myopathy. Short-term dietary nitrate supplementation has been shown to improve exercise performance and reduce oxygen cost of exercise in healthy humans and trained athletes. We investigated whether 1 wk of dietary inorganic nitrate supplementation decreases the oxygen cost of exercise and improves mitochondrial function in patients with mitochondrial myopathy. Ten patients with mitochondrial myopathy (40 ± 5 yr, maximal whole body oxygen uptake = 21.2 ± 3.2 ml·min−1·kg body wt−1, maximal work load = 122 ± 26 W) received 8.5 mg·kg body wt−1·day−1 inorganic nitrate (~7 mmol) for 8 days. Whole body oxygen consumption at 50% of the maximal work load, in vivo skeletal muscle oxidative capacity (evaluated from postexercise phosphocreatine recovery using 31P-magnetic resonance spectroscopy), and ex vivo mitochondrial oxidative capacity in permeabilized skinned muscle fibers (measured with high-resolution respirometry) were determined before and after nitrate supplementation. Despite a sixfold increase in plasma nitrate levels, nitrate supplementation did not affect whole body oxygen cost during submaximal exercise. Additionally, no beneficial effects of nitrate were found on in vivo or ex vivo muscle mitochondrial oxidative capacity. This is the first time that the therapeutic potential of dietary nitrate for patients with mitochondrial myopathy was evaluated. We conclude that 1 wk of dietary nitrate supplementation does not reduce oxygen cost of exercise or improve mitochondrial function in the group of patients tested.
Collapse
Affiliation(s)
- Miranda Nabben
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Genetics and Cell Biology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Joep P. J. Schmitz
- Computational Biology, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Jolita Ciapaite
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Natal A. van Riel
- Computational Biology, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Harm R. Haak
- Department of Internal Medicine, Máxima Medical Center, Eindhoven, The Netherlands
- Department of Internal Medicine, CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Irenaeus F. M. de Coo
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hubert Smeets
- Department of Genetics and Cell Biology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Stephan F. Praet
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; and
| | - Luc J. van Loon
- Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jeanine J. Prompers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
8
|
Lackinger C, Strehn A, Dorner TE, Niebauer J, Titze S. Health resorts as gateways for regional, standardised, sports club based exercise programmes to increase the weekly time of moderate- to vigorous-intensity physical activity: study protocol. BMC Public Health 2015; 15:1265. [PMID: 26692015 PMCID: PMC4687275 DOI: 10.1186/s12889-015-2581-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/08/2015] [Indexed: 11/22/2022] Open
Abstract
Background More than 10 % (approximately 60,000) of the adult population in Styria, a federal state in the south of Austria, is granted a residential stay in a health resort each year. The target group for these stays is the general population aged between 30 and 65 years with minor symptoms such as risk factors for cardio-metabolic diseases. Stays are financed by health insurance companies and last up to three weeks. The treatment during the stays consists of exercise and nutritional intervention as well as psychological support when needed. However, because of the absence of regional programmes linked with the residential stay, the sustainability of the interventions is questionable. Methods/Design This prospective, controlled, multicentre, open-label study will compare two groups. Participants will be included in the study if they live in any of eight predefined Styrian regions and do not meet the minimal WHO physical activity guidelines. Those allocated to the intervention group will receive a voucher for 12 regional, standardised, sports club based exercise sessions. The members of the control group will come from different but matched Styrian regions and will receive an informative written brochure. The primary outcome will be the weekly level of health-enhancing physical activity, which will be objectively measured with an accelerometer and supplemented by an activity log book. Together with potential determinants of physical activity it will be assessed before, 10 weeks after and 12 months after the residential stay. Additionally, psychosocial determinants will be assessed by questionnaire and fitness (cardiorespiratory fitness, handgrip, balance) will be measured. In addition to the changes in measurable parameters, processes will be evaluated to learn about the facilitators and barriers of the implementation of the programme. Discussion It is known that during the residential stay, participants are receptive to new opportunities supporting health behaviour change, but that these measures are not sustained after discharge. The structured cooperation between the health sector that has to inform the participants and the sports sector that provides the wide network of standardised programmes is the strength of the study, but at the same time a challenge. Trial registration ClinicalTrials.gov (Identifier: NCT02552134; date of registration: 15 September 2015)
Collapse
Affiliation(s)
- Christian Lackinger
- Department of Health Promotion and Prevention, SPORTUNION Österreich, Falkestrasse 1, 1010, Vienna, Austria.
| | - Albert Strehn
- Competence Center Health Promotion, SVA, Osterwiese 2, 7000, Eisenstadt, Austria.
| | - Thomas Ernst Dorner
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Josef Niebauer
- Institut of Sports Medicine, Prevention and Rehabilitation; Paracelsus Medizinische Privatuniversität Salzburg, Lindhofstr. 20, 5020, Salzburg, Austria.
| | - Sylvia Titze
- Institute of Sports Science, University of Graz, Mozartgasse 14, 8101, Graz, Austria.
| |
Collapse
|
9
|
Left atrial strain after maximal exercise in competitive waterpolo players. Int J Cardiovasc Imaging 2015; 32:399-405. [PMID: 26472580 DOI: 10.1007/s10554-015-0786-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
Left atrial (LA) function is a determinant of left ventricular (LV) filling. It carries out three main functions: reservoir, conduit, contractile. Aim of this study was to evaluate the role of LA and its deformation properties on LV filling at rest (R) and immediately after a maximal exercise (ME) through the speckle tracking echocardiography. Population enrolled was composed by 23 water polo athletes who performed a ME of six repeats of 100 m freestyle swim sets. At ME peak atrial longitudinal strain was reduced but all strain rate (SR) parameters increased, respectively positive peak SR at reservoir phase, SR negative peak at rapid ventricular filling (SRep) and SR negative peak at late ventricular filling (SRlp), that corresponds to atrial contraction phase. We showed a parallel increase in E and A pulsed Doppler wave and SRep and SRlp; particularly at ME, A wave and SRlp increased more respectively than E wave and SRep. SRlp was related to ejection fraction (EF) (r = -0.47; p < 0.01). At multivariate analysis SRlp was an independent predictor of EF (β: -0.47; p = 0.016). The increased sympathetic tone results into increased late diastolic LV filling with augmented atrial contractility and a decrease in diastolic filling time. During exercise LV filling was probably optimized by an enhanced and rapid LA conduit phase and by a vigorous atrial contraction during late LV filling.
Collapse
|
10
|
Mechanism-based population pharmacokinetic and pharmacodynamic modeling of intravenous and intranasal dexmedetomidine in healthy subjects. Eur J Clin Pharmacol 2015; 71:1197-207. [PMID: 26233335 DOI: 10.1007/s00228-015-1913-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Dexmedetomidine is an α2-adrenoceptor agonist used for perioperative and intensive care sedation. This study develops mechanism-based population pharmacokinetic-pharmacodynamic models for the cardiovascular and central nervous system (CNS) effects of intravenously (IV) and intranasally (IN) administered dexmedetomidine in healthy subjects. METHOD Single doses of 84 μg of dexmedetomidine were given once IV and once IN to six healthy men. Plasma dexmedetomidine concentrations were measured for 10 h along with plasma concentrations of norepinephrine (NE) and epinephrine (E). Blood pressure, heart rate, and CNS drug effects (three visual analog scales and bispectral index) were monitored to assess the pharmacological effects of dexmedetomidine. PK-PD modeling was performed for recently published data (Eur J Clin Pharmacol 67: 825, 2011). RESULTS Pharmacokinetic profiles for both IV and IN doses of dexmedetomidine were well fitted using a two-compartment PK model. Intranasal bioavailability was 82%. Dexmedetomidine inhibited the release of NE and E to induce their decline in blood. This decrease in NE was captured with an indirect response model. The concentrations of the mediator NE served via a biophase/transduction step and nonlinear pharmacologic functions to produce reductions in blood pressure and heart rate, while a direct effect model was used for the CNS effects. CONCLUSION The comprehensive panel of two biomarkers and seven response measures were well captured by the population PK/PD models. The subjects were more sensitive to the CNS (lower EC 50 values) than cardiovascular effects of dexmedetomidine.
Collapse
|
11
|
Liu HB, Yuan WX, Qin KR, Hou J. Acute effect of cycling intervention on carotid arterial hemodynamics: basketball athletes versus sedentary controls. Biomed Eng Online 2015; 14 Suppl 1:S17. [PMID: 25602805 PMCID: PMC4306107 DOI: 10.1186/1475-925x-14-s1-s17] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To compare the acute effects of a cycling intervention on carotid arterial hemodynamics between basketball athletes and sedentary controls. METHODS Ten young long-term trained male basketball athletes (BA) and nine age-matched male sedentary controls (SC) successively underwent four bouts of exercise on a bicycle ergometer at the same workload. Hemodynamic variables at right common carotid artery were determined at rest and immediately following each bout of exercise. An ANCOVA was used to compare differences between the BA and SC groups at rest and immediately following the cycling intervention. The repeated ANOVA was used to assess differences between baseline and each bout of exercise within the BA or SC group. RESULTS In both groups, carotid hemodynamic variables showed significant differences at rest and immediately after the cycling intervention. At rest, carotid arterial stiffness was significantly decreased and carotid arterial diameter was significantly increased in the BA group as compared to the SC group. Immediately following the cycling intervention, carotid arterial stiffness showed no obvious changes in the BA group but significantly increased in the SC group. It is worth noting that while arterial stiffness was lower in the BA group than in the SC group, the oscillatory shear index (OSI) was significantly higher in the BA group than in the SC group both at rest and immediately following the cycling intervention. CONCLUSION Long-term basketball exercise had a significant impact on common carotid arterial hemodynamic variables not only at rest but also after a cycling intervention. The role of OSI in the remodeling of arterial structure and function in the BA group at rest and after cycling requires clarification.
Collapse
|
12
|
Paap D, Takken T. Reference values for cardiopulmonary exercise testing in healthy adults: a systematic review. Expert Rev Cardiovasc Ther 2014; 12:1439-53. [DOI: 10.1586/14779072.2014.985657] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
13
|
Santoro A, Alvino F, Antonelli G, Cameli M, Bertini M, Molle R, Mondillo S. Left ventricular strain modifications after maximal exercise in athletes: a speckle tracking study. Echocardiography 2014; 32:920-7. [PMID: 25418356 DOI: 10.1111/echo.12791] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The increase in systolic indexes from rest (R) to exercise is achieved by combination of enhanced heart rate (HR) and stroke volume (SV). Aim of this study was to evaluate left ventricular (LV) longitudinal, circumferential, and torsional components immediately after a maximal intensity exercise (ME) by speckle tracking echocardiography (STE). METHODS Twenty-seven male water polo players performed an ME that consisted of 6 repeats of 100 m freestyle swim sets. An echocardiographic examination was performed before and after ME. STE was performed to obtain the analysis of LV myocardial deformation. RESULTS There were no differences between R and ME regarding LV longitudinal strains (PVLS). Apical circumferential LV strain (AVCS) and LV longitudinal strain rate (SR) increased at ME with respect to R (R: -23.1 ± 4.9%; ME: -28.4 ± 7.6%, P < 0.05; R: -1.1 ± 0.1/sec, ME: -1.5 ± 0.2/sec, P < 0.01). LV twisting (LVT) and untwisting (UTW) increased at ME (R: 7.9 ± 2.4°, ME: 14.2 ± 3.2°, P < 0.001; R: -107.2 ± 47.4; ME: -158.5 ± 61.5 °/sec; P < 0.01). At ME, apical rotation (Arot) had higher values than R values (5.4 ± 3.0°; 10.0 ± 6.0°; P < 0.01) and time-to-peak (TTP) of apical segments are earlier than all TTP. SV was related to LVT (r = 0.56, P = 0.01), AVCS (r = -0.59, P = 0.005) and Arot (r = 0.46, P = 0.04). At multivariate analysis, AVCS was the independent predictor of SV (β = -0.58; P < 0.05). CONCLUSIONS Apical fibers and LVT give the main contribution to systolic components at ME. The storage of energy during LVT, released during early diastole, seems to be a fundamental mechanism to support diastolic filling during maximal exercise.
Collapse
Affiliation(s)
- Amato Santoro
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy
| | - Federico Alvino
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy
| | | | - Matteo Cameli
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy
| | - Matteo Bertini
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy.,Department of Cardiology, St. Anna Hospital Ferrara, Ferrara, Italy
| | - Roberta Molle
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy
| | - Sergio Mondillo
- Division of Cardiology, University of Siena, Siena, Tuscany, Italy
| |
Collapse
|
14
|
Barclay K, Myrskylä M. Birth order and physical fitness in early adulthood: evidence from Swedish military conscription data. Soc Sci Med 2014; 123:141-8. [PMID: 25462615 DOI: 10.1016/j.socscimed.2014.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/28/2014] [Accepted: 11/04/2014] [Indexed: 11/24/2022]
Abstract
Physical fitness at young adult ages is an important determinant of physical health, cognitive ability, and mortality. However, few studies have addressed the relationship between early life conditions and physical fitness in adulthood. An important potential factor influencing physical fitness is birth order, which prior studies associate with several early- and later-life outcomes such as height and mortality. This is the first study to analyse the association between birth order and physical fitness in late adolescence. We use military conscription data on 218,873 Swedish males born between 1965 and 1977. Physical fitness is measured by a test of maximal working capacity, a measure of cardiovascular fitness closely related to V02max. We use linear regression with sibling fixed effects, meaning a within-family comparison, to eliminate the confounding influence of unobserved factors that vary between siblings. To understand the mechanism we further analyse whether the association between birth order and physical fitness varies by sibship size, parental socioeconomic status, birth cohort or length of the birth interval. We find a strong, negative and monotonic relationship between birth order and physical fitness. For example, third-born children have a maximal working capacity approximately 0.1 (p < 0.000) standard deviations lower than first-born children. The association exists both in small (3 or less children) and large families (4 or more children), in high and low socioeconomic status families, and amongst cohorts born in the 1960s and the 1970s. While in the whole population the birth order effect does not depend on the length of the birth intervals, in two-child families a longer birth interval strengthens the advantage of the first-born. Our results illustrate the importance of birth order for physical fitness, and suggest that the first-born advantage already arises in late adolescence.
Collapse
Affiliation(s)
- Kieron Barclay
- Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden.
| | - Mikko Myrskylä
- Department of Social Policy, 2nd Floor, Old Building, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK; Max Planck Institute for Demographic Research, Konrad Zuse Str. 1, 18057 Rostock, Germany; Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, 00014, Finland.
| |
Collapse
|
15
|
PhysioDroid: combining wearable health sensors and mobile devices for a ubiquitous, continuous, and personal monitoring. ScientificWorldJournal 2014; 2014:490824. [PMID: 25295301 PMCID: PMC4177226 DOI: 10.1155/2014/490824] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/07/2014] [Accepted: 08/20/2014] [Indexed: 11/17/2022] Open
Abstract
Technological advances on the development of mobile devices, medical sensors, and wireless communication systems support a new generation of unobtrusive, portable, and ubiquitous health monitoring systems for continuous patient assessment and more personalized health care. There exist a growing number of mobile apps in the health domain; however, little contribution has been specifically provided, so far, to operate this kind of apps with wearable physiological sensors. The PhysioDroid, presented in this paper, provides a personalized means to remotely monitor and evaluate users' conditions. The PhysioDroid system provides ubiquitous and continuous vital signs analysis, such as electrocardiogram, heart rate, respiration rate, skin temperature, and body motion, intended to help empower patients and improve clinical understanding. The PhysioDroid is composed of a wearable monitoring device and an Android app providing gathering, storage, and processing features for the physiological sensor data. The versatility of the developed app allows its use for both average users and specialists, and the reduced cost of the PhysioDroid puts it at the reach of most people. Two exemplary use cases for health assessment and sports training are presented to illustrate the capabilities of the PhysioDroid. Next technical steps include generalization to other mobile platforms and health monitoring devices.
Collapse
|
16
|
Vissing CR, Preisler N, Husu E, Prahm KP, Vissing J. Aerobic training in patients with anoctamin 5 myopathy and hyperckemia. Muscle Nerve 2014; 50:119-23. [DOI: 10.1002/mus.24112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/18/2013] [Accepted: 10/29/2013] [Indexed: 02/01/2023]
Affiliation(s)
- Christoffer R. Vissing
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Nicolai Preisler
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Edith Husu
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - Kira P. Prahm
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| | - John Vissing
- Neuromuscular Research Unit, Department of Neurology, Section 3342, Rigshospitalet; University of Copenhagen; Blegdamsvej 9, DK-2100 Copenhagen Denmark
| |
Collapse
|
17
|
Talaminos A, Roa LM, Álvarez A, Reina J. Computational Hemodynamic Modeling of the Cardiovascular System. INTERNATIONAL JOURNAL OF SYSTEM DYNAMICS APPLICATIONS 2014. [DOI: 10.4018/ijsda.2014040106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Computational methods and modeling are widely used in many fields to study the dynamic behaviour of different phenomena. Currently, the use of these models is an accepted practice in the biomedical field. One of the most significant efforts in this direction is applied to the simulation and prediction of pathophysiological conditions that can affect different systems of the human body. In this work, the design and development of a computational model of the human cardiovascular system is proposed. The structure of the model has been built from a physiological base, considering some of the mechanisms associated to the cardiovascular system. Thus, the aim of the model is the prediction, heartbeat by heartbeat, of some hemodynamic variables from the cardiovascular system, in different pathophysiological cardiac situations. A modular approach to development of the model has been considered in order to include new knowledge that could force the model's hemodynamic. The model has been validated comparing the results obtained with hemodynamic values published by other authors. The results show the usefulness and applicability of the model developed. Thus, different simulations of some cardiac pathologies and physical exercise situations are presented, together with the dynamic behaviors of the different variables considered in the model.
Collapse
Affiliation(s)
| | - Laura M. Roa
- CIBER-BBN, University of Seville, Seville, Spain
| | | | - Javier Reina
- CIBER-BBN, University of Seville, Seville, Spain
| |
Collapse
|
18
|
Brudin L, Jorfeldt L, Pahlm O. Comparison of two commonly used reference materials for exercise bicycle tests with a Swedish clinical database of patients with normal outcome. Clin Physiol Funct Imaging 2013; 34:297-307. [DOI: 10.1111/cpf.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 10/06/2013] [Indexed: 11/30/2022]
Affiliation(s)
- L. Brudin
- Department of Clinical Physiology; Kalmar County Hospital; Kalmar Sweden
- Department of Medicine and Health Sciences; University Hospital Linköping; Linköping Sweden
| | - L. Jorfeldt
- Department of Molecular Medicine and Surgery; Section of Clinical Physiology; Karolinska Institutet; Stockholm Sweden
- Department of Clinical Physiology; Karolinska University Hospital; Solna Sweden
| | - O. Pahlm
- Department of Clinical Physiology; Skåne University Hospital; Lund Sweden
| |
Collapse
|
19
|
Nes BM, Janszky I, Wisløff U, Støylen A, Karlsen T. Age-predicted maximal heart rate in healthy subjects: The HUNT Fitness Study. Scand J Med Sci Sports 2012; 23:697-704. [DOI: 10.1111/j.1600-0838.2012.01445.x] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 11/27/2022]
Affiliation(s)
- B. M. Nes
- K.G. Jebsen Center of Exercise in Medicine; Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
| | - I. Janszky
- Department of Public Health; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
| | - U. Wisløff
- K.G. Jebsen Center of Exercise in Medicine; Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
- Centre for Sports and Physical Activity Research; Norwegian University of Science and Technology; Trondheim Norway
| | - A. Støylen
- K.G. Jebsen Center of Exercise in Medicine; Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
- Department of Cardiology; St. Olavs University Hospital; Trondheim Norway
| | - T. Karlsen
- K.G. Jebsen Center of Exercise in Medicine; Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology; Trondheim Norway
| |
Collapse
|
20
|
Mannerkorpi K, Nordeman L, Cider A, Jonsson G. Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther 2010; 12:R189. [PMID: 20942911 PMCID: PMC2991024 DOI: 10.1186/ar3159] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 09/23/2010] [Accepted: 10/13/2010] [Indexed: 12/02/2022] Open
Abstract
Introduction The objective of this study was to investigate the effects of moderate-to-high intensity Nordic walking (NW) on functional capacity and pain in fibromyalgia (FM). Methods A total of 67 women with FM were recruited to the study and randomized either to moderate-to-high intensity Nordic Walking (n = 34, age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (LIW, n = 33, age 50 ± 7.6 years). Primary outcomes were the six-minute walk test (6MWT) and the Fibromyalgia Impact Questionnaire Pain scale (FIQ Pain). Secondary outcomes were: exercise heart rate in a submaximal ergometer bicycle test, the FIQ Physical (activity limitations) and the FIQ total score. Results A total of 58 patients completed the post-test. Significantly greater improvement in the 6MWT was found in the NW group (P = 0.009), as compared with the LIW group. No between-group difference was found for the FIQ Pain (P = 0.626). A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the FIQ Physical (P = 0.027) were found in the NW group as compared with the LIW group. No between-group difference was found for the change in the FIQ total. The effect sizes were moderate for the above mentioned outcomes. Conclusions Moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations. Pain severity did not change over time during the exercise period. Trial registration Clinicaltrials.gov identifier NCT00643006.
Collapse
Affiliation(s)
- Kaisa Mannerkorpi
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530 Göteborg, Sweden.
| | | | | | | |
Collapse
|
21
|
Tamás É, Nielsen NE, Vanhanen I, Nylander E. Measurement of physical work capacity in patients with chronic aortic regurgitation: a potential improvement in patient management. Clin Physiol Funct Imaging 2009; 29:453-7. [DOI: 10.1111/j.1475-097x.2009.00895.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
22
|
Hager A, Kanz S, Kaemmerer H, Hess J. Exercise capacity and exercise hypertension after surgical repair of isolated aortic coarctation. Am J Cardiol 2008; 101:1777-80. [PMID: 18549858 DOI: 10.1016/j.amjcard.2008.02.072] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 02/02/2008] [Accepted: 02/02/2008] [Indexed: 11/29/2022]
Abstract
There are contradictory reports whether exercise capacity is reduced in patients on long-term follow-up after coarctation repair. Data from unselected patient groups are missing. In a cross-sectional, long-term follow-up study of a tertiary congenital cardiology referral center, 260 patients (30.2+/-11.4 years old, 84 women), after surgical repair for isolated aortic coarctation (age at surgery 11.5+/-11.2 years), underwent a symptom-limited exercise test. Peak workload was 180+/-52 W, significantly less than the age- and height-related reference values (p<0.0005). A peak workload under 80% of expected was found in 200 patients (77%). Exercise performance of the patients was independent from age at surgery, type of surgery, or the systolic brachial-ankle blood pressure difference. The only exercise-limiting factor found was the chronic administration of diuretics to treat hypertension (p=0.005). Exercise hypertension, defined as a systolic blood pressure >2 SD above the load-dependent reference value, was found in 73 patients (28%). It was independently related to the systolic brachial-ankle blood pressure difference (p<0.0005) and diuretics administration (p=0.037). In conclusion, most patients after coarctation repair have a reduced exercise performance. This reduction is not related to the surgical results. Particularly, as these patients are at risk of early atherosclerosis, exercise should be promoted as primary prevention after restenosis, aortic or cerebral aneurysms, and severe exercise hypertension are ruled out.
Collapse
Affiliation(s)
- Alfred Hager
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
| | | | | | | |
Collapse
|
23
|
Lobo T, Morgan J, Bjorksten A, Nicholls K, Grigg L, Centra E, Becker G. Cardiovascular testing in Fabry disease: exercise capacity reduction, chronotropic incompetence and improved anaerobic threshold after enzyme replacement. Intern Med J 2008; 38:407-14. [DOI: 10.1111/j.1445-5994.2008.01669.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Lötscher F, Löffel T, Steiner R, Vogt M, Klossner S, Popp A, Lippuner K, Hoppeler H, Däpp C. Biologically relevant sex differences for fitness-related parameters in active octogenarians. Eur J Appl Physiol 2007; 99:533-40. [PMID: 17219173 DOI: 10.1007/s00421-006-0368-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2006] [Indexed: 12/21/2022]
Abstract
The number of elderly people is growing in western populations, but only few maximal performance data exist for people >75 years, in particular for European octogenarians. This study was performed to characterize maximal performance of 55 independently living subjects (32 women, 81.1 +/- 3.4 years; 23 men, 81.7 +/- 2.9 years) with a focus on sex differences. Maximal performance was determined in a ramp test to exhaustion on a bicycle ergometer with ergospirometry, electrocardiogram and blood lactate measurements. Maximal isometric extension strength of the legs (MEL) was measured on a force platform in a seated position. Body composition was quantified by X-ray absorptiometry. In >25% of the subjects, serious cardiac abnormalities were detected during the ramp test with men more frequently being affected than women. Maximal oxygen consumption and power output were 18.2 +/- 3.2 versus 25.9 +/- 5.9 ml min(-1) kg(-1) and 66 +/- 12 versus 138 +/- 40 W for women versus men, with a significant sex difference for both parameters. Men outperformed women for MEL with 19.0 +/- 3.8 versus 13.6 +/- 3.3 N kg(-1). Concomitantly, we found a higher proportion of whole body fat in women (32.1 +/- 6.2%) compared to men (20.5 +/- 4.4%). Our study extends previously available maximal performance data for endurance and strength to independently living European octogenarians. As all sex-related differences were still apparent after normalization to lean body mass, it is concluded that it is essential to differentiate between female and male subjects when considering maximal performance parameters in the oldest segment of our population.
Collapse
Affiliation(s)
- Fabian Lötscher
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, 3000, Bern 9, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Ohrström M, Davidsson T, Månsson W, Wohlfart B, Ekelund M. Working Capacity and Well-Being after Radical Cystectomy with Continent Cutaneous Diversion. Eur Urol 2006; 49:691-7. [PMID: 16442699 DOI: 10.1016/j.eururo.2005.12.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Accepted: 12/15/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The primary aim was to compare the working capacity in patients with continent urinary diversion with a control group. Secondary aims were to assess the changes in electrolyte and acid-base homeostasis and the functional status during strenuous physical activity, and finally, the well-being in the two groups. METHODS Eleven patients who had undergone radical cystectomy and continent cutaneous diversion using an ileocolonic segment participated. The control group consisted of 12 men, matched for age and activity level. Working capacity was assessed by ergospirometry on an exercise bicycle. Venous blood samples were taken before the test, when the expiratory exchange ratio (RER) was about 1.0 and immediately after completion of the test. SF-36 was used to evaluate the subject's functional status and well-being. RESULTS The median working capacity in the patient group was 155 (85-190) W and 155 (125-215) W in the control group (n.s.) corresponding to 72 (43-97) % and 80 (59-97) % respectively of predicted values. Peak oxygen uptake was somewhat low in both groups when compared to P-O Astrands norms. Blood tests revealed that patients developed a slight metabolic hyperchloremic acidosis, not seen in the control group. There were no differences between the groups as assessed with SF-36. CONCLUSION Patients with a continent urinary diversion have a working capacity equal to a control group despite a slight metabolic hyperchloremic acidosis. Quality of life was similar in the two groups and corresponded well with the norms for the general Swedish population aged 65 to 74.
Collapse
Affiliation(s)
- Margareta Ohrström
- Department of Health Sciences, Division of Physiotherapy, Lund University Hospital, S-221 85 Lund, Sweden.
| | | | | | | | | |
Collapse
|
26
|
Ohrström M, Jansson O, Wohlfart B, Ekelund M. Working capacity and resting energy expenditure after ileal pouch-anal anastomosis. Br J Surg 2004; 91:618-24. [PMID: 15122615 DOI: 10.1002/bjs.4519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The aim was to evaluate the working capacity and resting energy expenditure in patients who had undergone restorative proctocolectomy. METHODS Of 72 patients operated on between April 1990 to September 1998, 51 were eligible and 38 participated in the study. Resting energy was assessed by indirect calorimetry, and working capacity by ergospirometry on an exercise bicycle. RESULTS The median functional score was 2 (range 0-7). Oxygen uptake during rest was reduced for men compared with predicted values. The corresponding values for women were in keeping with predicted values. The median working capacity was 96 (range 59-102) per cent for women and 91 (range 51-113) per cent for men, compared with reference values of maximum workload based on age, height and sex. There was no correlation between functional score and any other variable measured. CONCLUSION Patients who have undergone restorative proctocolectomy for ulcerative colitis have normal resting energy expenditure and working capacity.
Collapse
Affiliation(s)
- M Ohrström
- Department of Physiotherapy, Lund University Hospital, Lund, Sweden.
| | | | | | | |
Collapse
|